If it's for non Medicare covered services, you are going to have to pay out of pocket for a local private agency (around $25-$30/hr in my area). Medicare will only pay for a condition that can be improved, not for something like dementia or Parkinson's. So if Mom has a condition that Medicare won't approve payment for, she is going to have to pay. if she can't afford it, or if by paying it will use up her savings fast, begin the process of applying or exploring Medicaid in your state. I just went through this with my father. (Shane's response here is exactly right from the research I've done)
A MD must order Home Care. This is usually ordered after someone has been hospitalized and/ or in patient rehab and needs home care to help the person adjust. Without a hospitalization she would need to be seen by her PCP who then has to justify his order to Medicare if she meets the requirements. Home Care episodes are 60 days....& can be recertified if needed for another 60 but requires a huge amount of medical justification. That’s why it’s so much easier to obtain homecare after a hospitalization. Medicare figures if the person can’t improve after another 60 days that person needs SNF or AL. Then you’d need to apply for Medicaid to pay the SNF or out of her funds until Medicaid approved. Homecare paid by Medicare will cease.
This does not mean that your mother will need HC for 60 days; the homecare professional staff ( PT, OT & RN) can recommend discharge if the patient is not improving. Cases can continue without an RN for the 60 day period as the physical therapist can oversee the patients needs and the need for SN has been completed.
This may be the only circumstances when Medicare pays for homecare, and the episode of “certification period” is 60 days. And during that Home Care episode PT, OT, RN, ST, SW & bath aide will provide care consistent with the patients needs, stabilize them and then close the homecare 60 day episode. This doesn’t mean she will need all the disciplines noted above, but are available if ordered. Nor am I an expert on Medicare and what they cover or not cover.
If your mother has assets she will need to spend them down to $2K. There are many posts on this site about assets and how you get Medicaid is not my forte.
Look up agencies in your area who provide home care. They will come and assess the situation and let you know what it will cost. The actual care givers, who work for the agency, will recieve about half of what you will pay. You might try several agencies to see who seems most reliable. Let them know exactly what you expect to be done.
This does not mean that your mother will need HC for 60 days; the homecare professional staff ( PT, OT & RN) can recommend discharge if the patient is not improving. Cases can continue without an RN for the 60 day period as the physical therapist can oversee the patients needs and the need for SN has been completed.
This may be the only circumstances when Medicare pays for homecare, and the episode of “certification period” is 60 days. And during that Home Care episode PT, OT, RN, ST, SW & bath aide will provide care consistent with the patients needs, stabilize them and then close the homecare 60 day episode. This doesn’t mean she will need all the disciplines noted above, but are available if ordered. Nor am I an expert on Medicare and what they cover or not cover.
If your mother has assets she will need to spend them down to $2K. There are many posts on this site about assets and how you get Medicaid is not my forte.
Good luck!